The coroner's report is detailed: The deceased was wearing a blue long-sleeved T-shirt, a blue undershirt and two pairs of jogging pants. That's how cold it was. Egyptian Ahmed Elgamal had died of carbon monoxide poisoning while sleeping in his tent at the Moria refugee and migrant center on the Greek island of Lesvos on January 24, 2017. Two more people died of the same cause within just a week of that incident while trying to stay warm with makeshift stoves. Almost two years on, Elgamal's parents are seeking justice for the death of their 20-year-old son.

Dozens of tents have gone up at a makeshift spillover camp on the periphery of the overcrowded migrant reception and identification center at Moria on Lesvos.

Mohamed and Yusreia Elgamal filed suit against the Greek state, which is responsible for the operation of the Moria camp, with Athens's Administrative Court of First Instance on Thursday, November 22. The family is represented by lawyer Sikina Pavlaki and it is the first time in Greece's judicial history that someone has sought reparations over the horrendous living conditions at the official migrant reception and identification center.

Elgamal was born in a village in the Dakahlia region of Egypt in 1997. He studied business administration in Mansoura but decided to leave Egypt before finishing the course. His parents said he made the decision due to insufficient resources and the suppression he felt from the regime.

He reached Turkey in November 2016 and spent around 10 days there before being smuggled by boat to Lesvos, along with 12 other people of different nationalities, all aiming to apply for asylum.

According to the lawsuit, documents from which Kathimerini has seen, Elgamal spoke with his parents by telephone, telling them that he was staying in a tent with other refugees and was waiting to see whether he would be deported or could find some way to stay in Greece. They say he sounded desperate as he described incidents of violence and daily outbursts of tension, and standing in line for hours just to eat.

Freezing temperatures

As the weeks rolled by, however, Elgamal's complaints began to focus on just one thing: the bitter cold. He spoke to his parents of suffering from it, of having no means of staying warm in his tent. Other than wearing several layers of clothing, during the day he would also wrap himself in a waterproof jacket he had been given and a blanket on top of that.

In one photograph of Elgamal found by Kathimerini, the 20-year-old Egyptian is seen sitting inside his tent in such a bulky outfit, with a T-shirt wrapped around his head for warmth.

Ahmed Elgamal is seen in his tent at Moria.

Like so many other residents of the camp, these conditions were unprecedented for Elgamal. In early January 2017 their tents were covered in snow – something many had only seen in pictures. The 20-year-old's telephone calls to his parents became even more desperate. He spoke of a cough and fever, and said he was scared he was going to die.

Photographs taken by Moria camp residents show snow covering the tents in the winter of 2017.

Like many, he and the other men in his tent tried to stay warm by building makeshift stoves that they'd place near the entrance to their tents. In their lawsuit, Elgamal's parents claim that despite the risks, this was a practice that was encouraged by the staff at the Moria center at the time. The night of January 23, 2017, was another hard one for Elgamal, and he wasn't able to fall asleep until around 1.30 on the 24th. He never woke up.

Clenched fistsς

One of Elgamal's tent mates, Syrian Mustafa Mustafa, told investigators that even though the young Egyptian had not gotten up by 12.30 p.m. the following day, “we didn't stir him because we thought he was still asleep.” When 4 p.m. rolled around, they got seriously worried and then noticed that Elgamal was unconscious and his skin was freezing cold. His hands were also clenched in fists.

Mustafa Mustafa standing in the snow at Moria.

Kathimerini has learned that 46-year-old Mustafa is the only witness who testified to the police. Just four days later, he also died in his sleep from the same cause. It seems that no one had warned those living in tents of the risks of sleeping with their makeshift stoves turned on. The third death in just a week was that of Jat Wares Ali, a Pakistani national.

Toxic fumes

In November 2017, 10 months after those three consecutive deaths, Kathimerini presented its own investigation of the incidents with the story of Mustafa (“One week, three dead, zero accountability”). At the time, the Greek authorities had not ruled on the cause of death and the victims' families did not have any answers.

“It is degrading here. Gangs and the mafia steal from people on the island and in the camps and the police do not get involved. You can get stabbed and the police won’t do anything,” Mustafa had said in a 46-second WhatsApp voice message to his sister, who lives in the Netherlands. Just a few days later, he died in his tent.

In the case of both Elgamal and Mustafa, the death certificate signed by coroner Theodoros Nousias and seen by Kathimerini, says that the cause of death is “undetermined, pending toxicological and histological tests.”

Mustafa Mustafa's death certificate.

On February 7, 2017, the toxicological report by the Athens Medical School's Forensic Medicine Department showed that Elgamal had not taken any drugs or alcohol. An earlier test from January 31 had found that his blood contained a carboxyhemoglobin (COHb) concentration of 61 percent. (COHb is a compound formed in the bloodstream when carbon monoxide is inhaled.)

While carbon monoxide has no color or smell, it is extremely toxic and hard to detect. It can cause nausea, dizziness and shortness of breath, among other symptoms, while in large concentrations it can lead to asphyxia and death. Even if someone survives exposure to the toxic gas, they will likely have some form of permanent brain damage.

Slow action

After the third death at Moria, the migration minister at the time, Yiannis Mouzalas, said that the Greek state has a “duty to investigate the incidents quickly” and take measures to improve living conditions. This did not happen.

In the case of Elgamal, for example, the coroner's report took more than 10 months to complete even though the toxicological tests had been ready since February 7, 2017. In fact, a former official of the Migration Ministry had told Kathimerini at the time that without a coroner's report it was impossible to begin assigning blame for the deaths.

Then migration minister Yiannis Mouzalas during a visit to Moria in 2017, just a few days before the third death at the camp. (Photos: ANA-MPA)

In that period, police authorities on Lesvos (possibly spurred by Kathimerini's insistent questioning on the course of the investigations) submitted their case files to the Mytilene first instance prosecutor three times: on April 13, May 25 and August 30, 2017. The prosecutor did not get the coroner's report on Elgamal until December 12 of that year. In it, the expert found signs of myocardial injury, inhalation of gastric contents and acute carbon monoxide poisoning.

On January 20, 2018, the Mytilene first instance prosecutor archived the case after concluding that no offense had been committed. The file contained just one witness testimony, that of Mustafa Mustafa.

‘They knew the risks’

As far as the young Egyptian man's parents are concerned, everyone in charge at the Moria camp was aware of the dangers presented by the cold weather and had failed to take action to ensure better living conditions for the residents. In their lawsuit, they claim that makeshift woodstoves were being used even in the half-covered areas where food was distributed.

Elgamal's family cites warnings issued by several nongovernmental organizations, but also a report by the National Committee for Human Rights that had been published before the three deaths. According to this report:

“Without clear and prompt instruction from the government regarding measures for the winter, the cold and rain from October on will make conditions unbearable.”

This winter

Winter 2018 has already arrived and Moria is still in no condition to see through another cold season. According to the register of the Migration Ministry's National Coordination Center for Border Control, Immigration and Asylum, the number of residents at Moria on November 21 stood at 5,860, when the camp was built for just 3,100 people. Another register compiled by a nongovernmental organization estimates that the number of refugees and migrants living in the olive grove spillover camp came to 1,498.

Newcomers are given a blanket and a bedsheet, while clothing donations are delivered to the island. Hopes that the tents outside the camp will ever be provided with some form of heating are nothing short of a pipe dream. Exposed to the elements, the people living there still try to stay warm using makeshift woodstoves.

Despite intermittent efforts to relieve the pressure on the crowded camp, there are families who are unwilling to leave the area because they are worried they will be moved to a remote part of the mainland, far away from a town or city.

Children are much more exposed to danger because of substandard conditions.

The NGO Doctors Without Borders has been carrying out a vaccination program for children outside the Moria camp, concerned that minors run an even greater risk of contracting serious illnesses in the winter. “We see 100 children every day. The majority are treated for respiratory infections and diarrhea, which are directly related to their living conditions,” Doctors Without Borders program coordinator Apostolos Veizis tells Kathimerini.

Of the three men who died in their sleep in Moria in 2017, only the eldest, Mustafa Mustafa, had a family of his own. He had six children and before the Syrian civil war worked at a furniture factory.

Mustafa with his daughters.

Elgamal had an uncle who had spent several years in Greece before the young man arrived from Egypt. The 20-year-old had been planning to look for him if he ever managed to leave Moria, but hadn't ruled out trying to reach another country in the European Union. The pair never got the chance to meet.

Other refugees staying at the camp who knew all three victims did not have a clear picture about what happened – a sign that they had not been warned of the risks of carbon monoxide poisoning. In a Facebook post, a Syrian friend of the first two victims actually indicated that he thought they had died of tuberculosis.

A Facebook post laments the death of Ahmed Elgamal and Mustafa Mustafa.

Elgamal last spoke to his parents just hours before he went to sleep on his last day. He was crying and kept saying that he was freezing to death.